Asperger's Frequently Confused with Other Psychiatric Disorders - Autism Awareness

Asperger’s Frequently Confused with Other Psychiatric Disorders

HOUSTON–Doctors often diagnose children with attention deficit disorders, learning disabilities or bipolar disorder when their patients actually have Asperger’s—a developmental disorder that inhibits the ability to socialize well with others…

( HOUSTON–Doctors often diagnose children with attention deficit disorders, learning disabilities or bipolar disorder when their patients actually have Asperger’s—a developmental disorder that inhibits the ability to socialize well with others.

Misdiagnosing the disorder prevents patients from receiving proper treatment and learning important skills for success in social settings, school and relationships. While a diagnosis can be made for Asperger’s Disorder as early as 2 years old, most children are not diagnosed until they reach middle school or later (see sidebar for common characteristics of Asperger’s Disorder).

“There is a huge confusion over what Asperger’s is and what it isn’t because it has only been diagnosed by the present criteria for the past 12 years,” says Dan Hoover, PhD, a psychologist with the Adolescent Treatment Program at The Menninger Clinic and associate professor in the Menninger Department of Psychiatry & Behavioral Sciences at Baylor College of Medicine. “Asperger’s is over diagnosed by some clinicians who are looking for it, and missed by clinicians who don’t know what to look for, or who do not want to give their patients the label of having Asperger’s Disorder.”

A combination of environmental and genetic factors may contribute to the development of the disorder, but the exact cause is unknown. Mental health experts believe Asperger’s disorder is similar to autism because it affects the areas of the brain that control communication. However, symptoms of Asperger’s Disorder are not as severe as autism.

Children with Asperger’s disorder may be highly intelligent and can communicate with others—they just don’t do it well. They are preoccupied with special interests like trains, motors, dinosaurs or Internet gaming. They also often speak in an idiosyncratic style that is hard for outsiders to understand.

“Patients with Asperger’s are limited in brain areas that enable people to understand subtle cues,” says Dr. Hoover, who treats individuals with the disorder. “They don’t reciprocate in conversation and tend to lecture others about subjects, and they don’t notice if the person who they are talking with looks bored or has no interest in the subject.”

Because children with Asperger’s disorder can’t communicate well, they seem odd and may be singled out for ridicule among their peers. Over time, because of their negative experience with people, patients with Asperger’s disorder distrust others and seek further isolation. Many people may misinterpret their behavior as rudeness, when in actuality, “almost everyone with Asperger’s wants to relate to others,” Dr. Hoover says, adding that patients with Asperger’s become depressed or act out when they can’t connect with other people or make friends.

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While there is no cure for Asperger’s, people with the disorder can learn social skills to help them better relate to people. Some therapists recommend patients use scripts that spell out exactly what to do and say in a social situation. Therapists and parents may also encourage children with Asperger’s to dress in a way that helps them fit in rather than stand out. Persons with Asperger’s often dress oddly, for example in mismatched or unfashionable clothes.

Antidepressants can help patients with Asperger’s deal with the depression that commonly accompanies the disorder. Physicians and psychiatrists may also prescribe attention deficit hyperactivity disorder (ADHD) stimulant medications to help patients with their impulsivity or disorganization, or antipsychotic medications for patients who act out or who are irritable and aggressive.

Patients diagnosed early with Asperger’s do best at learning how to adapt to their disorder, Dr. Hoover says. Parents who are concerned that their child may have symptoms of Asperger’s should schedule a visit with a trained child psychologist or psychiatrist to rule out other behavioral or psychiatric disorders.

“Many people think that patients with Asperger’s are stuck that way, but I have seen real change in some of the patients I have treated,” Dr. Hoover says. “A big part of getting better is knowing what Asperger’s is and doing something about it.”

Common characteristics of child with Asperger’s Disorder

  •  Has difficulty interpreting non-verbal gestures such facial expressions, body language and gestures
  •  Avoids eye contact with other people • Fails to make friends with children the same age
  •  Doesn’t share enjoyment, interests or achievements with other people
  •  Often insistent on following inflexible rituals or routines
  •  Not comfortable with own body; clumsy
  •  Preoccupied with parts of objects and special interests

The Menninger Clinic is an international specialty psychiatric center, providing innovative programs in treatment, research and education. Founded in 1925 in Kansas, Menninger relocated to Houston in 2003 and is affiliated with Baylor College of Medicine and The Methodist Hospital.

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  1. Cody says:

    Hi! My name is Cody. I’m 26 years old, and I believe I may have Aspergers. I grew up knowing that I felt different than my peers and I wasn’t able to process information the same way that others could. I struggled horribly in school and because of this, I couldn’t stand it. I remember as early as elementary school when my first run in with mental health issues began. I was placed in assisted learning classes all the way through elementary, middle, and high school. Never in that whole time did I get an official diagnosis, despite extensive tests being ran. I do not, however, believe Aspergers was one of those tests. I was given a “soft” diagnosis of having dyslexia. It did not, however, account for many other issues I was dealing with. In college, I continued to struggle with classes, mental health, time management, and much more. That’s when I was approached by a professor who encouraged me to seek guidance from a physician. This is when I was diagnosed and medicated for ADHD and depression. This brings me to last week when my girlfriend pointed out specific tendencies that I have, almost all of which are on this list for Aspergers. When I began doing research and going through this list, I sat my mother and girlfriend down and they both checked the majority of these items off the list. I’ve since read many things discussing the miss-diagnosis of people with Aspergers with those exact things, adhd and dyslexia. My mom said the reason she never believed I had it was because of the rumor that children with Aspergers aren’t athletic, and I have been a very gifted athlete my whole life, even as a small child. I had a very successful college track career. And through athletics I made friends. Although I struggle with many social cues and interactions, I don’t have an extreme social turn off like some individuals with Aspergers I’ve met. So I guess my question is, now what? 

  2. Christy says:

    Thank you both for sharing. My son has just turned 10 and I know that aspergers is the correct diagnosis. He was diagnosed with epilepsy in 2017, but I have been trying to figure this out since he was four. Under the care of a neurologist, psychologist and psychiatrist I was always told he had a disturbance disorder due to death & divorce so therefore he had anxiety & depression. I have recently contacted all of his doctors to tell them I know what he has & that I need to know where to go now. It is time to really help my son. He is very angry & aggressive….& I just feel guilty

  3.  My son has most of those things on the list he has been diagnosed with ADHD along with developmental delays and mild intellectual disability processing disorder and sensory issues. The problem is I feel ADHD doesn’t  fit the bill,  my oldest child has ADHD  and her symptoms are correct and spot on. My son  on the other hand still has repetitive behaviors special interest in objects. And interest that has been since he was the age of 4. I went to a neurologist and psychologist to get him tested again I hope they don’t say behavioral disorders or ADHD, Again because that’s not what he has. I have done tremendous amount of research and Asperger  fits the bill.

    • Emily, keep pursuing the diagnosis that you feel is correct. Parental observation is often not taken into account, yet parents are the ones who observe their children all the time and see those red flags. It took me seeing 3 different doctors before I could get a diagnosis for my son. The first doctor told me I was a panicked first time mother, the second said he didn’t seem to have autism, and the third one observed him for 12 weeks in an assessment program and he received the diagnosis. I was taken more seriously for my daughter’s diagnosis once my son was diagnosed.

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